Comparison Of Anterolateral And Posterolateral Approaches For Total Hip Replacement For Femoral Neck Fractures

Objective: By comparing the anteroposterior and posterolateral approach total hip replacement for the treatment of femoral neck fracture clinical efficacy and differences for the clinical choice of surgical options to provide a certain statistical basis.Methods: This retrospective analysis from August 2015 to August 2017 in our department for a single femoral neck fracture diagnosis of total hip arthroplasty in 62 cases of elderly patients were followed up for more than 6 months.Patients were divided according to the surgical approach: observation group(anterolateral approach group)31 cases,13 males and 18 females,the age range of 60-78 years old,with an average of 67.65 ± 4.79 years old,BMI index range of 16-26 with an average of 23.44 ± 1.90,Garden III type in 14 cases,Garden IV type in 14 cases,and posterior lateral approach group in 31 cases,15 males and 16 females,with an age range of 60-79 years with an average of 68.26 ± 4.79.The BMI Range 17-27,average 23.21 ± 2.22,Garden III 19 cases,Garden IV 12 cases.The surgical incision length,operation time,intraoperative blood loss,postoperative drainage,postoperative hospital stay,postoperative 6 weeks,3,6 months hip Harris score and postoperative complications were compared,And for statistical analysis.Results: All patients completed the surgery successfully.In the anterolateral approach group,the average incision length was 9.08±0.54 cm,and the average operation time was104.68±5.08 minutes.The average intraoperative blood loss was 335.81±16.50m1,and the average postoperative drainage volume was 77.90±5.64m1.The average hospital stay was At 9.23±2.19 days,Harris hip score was 76.16±2.46 at 6 weeks postoperatively,Harris hip score was 86.23±3.58 at 3 months postoperatively,and Harris hip score was 92.10±2.73 at6 months postoperatively;posterolateral entrance The average incision length in the road group was 13.65±0.98 cm,and the average operation time was 89.90±6.52 minutes.The average blood loss during the operation was 349.55±20.38.The average postoperativedrainage volume was 81.35±5.55.The average hospital stay was 12.06±2.39 days.Harris hip score was 68.26±5.57 at 6 weeks postoperatively,and Harris hip score was83.35±5.547 at 3 months postoperatively.Harris hip score was 91.58±2.68 at 6 months postoperatively.There was a significant difference in Harris hip scores between the two groups in length of surgical incision,operative time,intraoperative blood loss,postoperative hospital discharge time,and postoperative 6 and 3 months Harris hippocampus score(P<0.05);There was no significant difference in Harris hip score and postoperative complications at 6 months after operation(P>0.05).Conclusion: For total hip arthroplasty in elderly patients with femoral neck fractures,the choice of anterolateral and posterolateral approaches has a significant difference in postoperative recovery.The anterolateral approach has certain advantages in surgical incision,intraoperative bleeding,postoperative drainage volume,length of stay,and prevention of dislocation;the posterolateral approach has certain advantages in the intraoperative femoral side exposure,and the operation is less difficult.